Motivational Interviewing
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Transcript Motivational Interviewing
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What Keeps
Adolescents
Moving Forward in
Treatment?
Motivational Interviewing
Techniques in Juvenile Drug
Court
Developed by NDRI, Inc.
www.ndri.org
Joe Lunievicz, BA, RYT
Director Training Institute
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Dyads:
What Motivated You?
What was most important
to you:
• When you were 13?
•
When you were 16?
•
When you were 19?
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What Motivates your
participants to move
towards graduation?
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Important Considerations
Adolescence
Autonomy
The
is about identity.
issues are powerful.
adolescent brain is still developing.
Adolescent
culture and values are different
than adult culture and values.
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Why not just change?
Keep
in mind the family dynamics
adolescents go home to:
Do
their parents use?
Were they born addicted?
Are they safe?
Have they witnessed the unimaginable?
Are there co-occuring mental health issues?
Are there learning disabilities?
How early did they start using?
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Motivational Interviewing
A directive, client-centered
counseling style for eliciting behavior
change by helping clients to explore
and resolve ambivalence. It is a style
of helping that uses a set of specific
strategies.
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Motivational Interviewing
(Cont.)
Motivation- or presumed lack of it- is not
viewed as a personality problem or
character trait, but as a state of readiness
for change that can be influenced by a
helping relationship.
Rollnick & Miller, 1995
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MI Basic Principles
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Expressing Empathy
Developing Discrepancy
Rolling with Resistance
Supporting Self-Efficacy
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Why use MI in Drug Court?
Better
More
Engagement
Information
Better
Assessments
More
Relevant Recommendations
More
Successful Outcomes
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“You
don’t understand.”
“You won’t understand.”
- Anonymous Adolescent
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Seek first to understand,
then to be understood.
-Stephen R. Covey
7 Habits for Highly Effective People
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MI Strategies - OARS
Open
Ended questions
Affirm
Reflection
Summarize
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Impact of Communication
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Open Ended Questions
Who, what, where, when
Tell
me about…
How
did you…
Redirect: Now
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tell me about…
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Open-ended Examples:
What
worries you about your current situation?
What
difficulties have you had with your drug use?
What
do you think will happen if you don’t change?
How
has your anger interfered with your life?
What
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would your life be like 5 years from now?
Practice:
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Open-ended
Questions
Interview your partner by
asking only open ended
questions.
Buzzer sounds whenever a
closed ended question is
asked.
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Affirm (but don’t flatter)
Strengths
based technique
Verbally
supports or validates a
participant’s thoughts, emotions, or actions
Demonstrates: Appreciation,
Understanding, Support
When
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you see a strength, notice it
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Affirmation Example:
1. Participant arrives on time for his case
management appointment.
“You’re punctual. That will be a big help in this
program.”
2. Participant: “I don’t want to do anything more than
I need to. I just want to finish the program and get on
with my life.”
“Determination is a good characteristic to have in
treatment. It will help to keep you focused.”
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Practice:
Affirming
Read the statement to
your partner and your
partner must respond
with a strength’s based
affirmation.
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Reflective Listening
Rationale
Conveys willingness
to try to understand
Serves as a
perception check
Clarifies
feelings
Leads to more
exploration
Demonstrates
empathy
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Common Errors
Not listening
closely
Limited feeling
vocabulary
Monotone vocal
qualities
Premature focus on
problem solving
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Reflection
Expressing Empathy:
“So, what I hear you saying is…”
Reflecting Conflict:
“On the one hand…but on the other hand…”
“So what you’re saying is…but you are not able
to…”
Rolling with resistance:
“You don’t have to do anything you don’t want to.”
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Practice:
1.
2.
3.
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Reflection
Paraphrase
Reflect conflict
Roll with resistance
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Summarizing
The
Let
set-up statement
me see if I understand correctly…
Reflection, Reflection, Reflection
Open
What
ended Question
did I miss?
What other concerns do you have?
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Practice: Summarize
•
Let me see if I
understand correctly…
•
•
Reflection
Reflection
Reflection
•
What did I miss?
•
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Questioning Skills
Effective vs. Ineffective Questions
Ineffective
Too many questions
Accusatory questions: Why?
Multiple questions
Explanatory questions
Closed questions
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Questioning Skills
Effective vs. Ineffective Questions
Effective
Have specific objectives in mind
State background for question
Use language of the client
Check out whether client is understanding
Ask openly: Who, What, When, Where &
How
Use open-ended questions
Paraphrase; Reflect; Summarize
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Resources: EBPs that Address
Adolescents
Behavior Therapy (BT)
Cognitive-Behavioral Therapy (CBT)
Motivational Interviewing (MI)
Motivational Enhancement Therapy/Cognitive Behavioral
Therapy (MET/CBT
Relapse Prevention Therapy (RPT)
Adolescent Community Reinforcement Approach (A-CRA)
Seeking Safety (SS)
National Registry of Evidence-based Programs and Practices, SAMHSA
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Resources: EBTs that Address
Familial Issues
Multisystemic Therapy (MST)
Addresses COD issues also
Brief Strategic Family Therapy (BSFT)
Functional Family Therapy (FFT)
Family Behavior Therapy (FBT)
Addresses COD issues also
From: Evidence-Based Practice Recommendations for Juvenile Drug Courts by
the National Center for Mental Health and Juvenile Justice in collaboration
with the Louisiana Supreme Court Drug Court Office - 2009
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Resources: EBTs that Address
CODs
Trauma Focused Cognitive Behavioral Therapy (
Motivational Enhancement Treatment (MET, CBTS)
Individual, outpatient modality
Individual and Group sessions
Continuous, Comprehensive, Integrated System of Care
Nodel (CCISC)
A set of practice guidelines for dual diagnosis treatment
From: Evidence-Based Practice Recommendations for Juvenile Drug Courts by
the National Center for Mental Health and Juvenile Justice in collaboration
with the Louisiana Supreme Court Drug Court Office - 2009
Lunievicz/MI/